TrumpCare under scrutiny: What to watch for in the CBO score

The Congressional Budget Office will release its score of the revised GOP health care effort to repeal and replace the Affordable Care Act Wednesday, an important analysis that could alter the path of the Trump administration’s health care legislation.

Democrats chastised what they viewed as the GOP’s effort to rush the American Health Care Act through the U.S. House of Representatives earlier this month, before it had been properly vetted by the CBO. The CBO’s original predictions contributed to the botched rollout of the initial bill, which was pulled in March before even reaching the House floor due to lack of support. Any new negative figures could provide Democrats with more ammunition to campaign against the effort as the GOP looks to send the bill to the Senate.

The CBO, a nonpartisan group, will forecast how the new bill will impact coverage, federal costs and premiums throughout the next 10 years. Here are some key figures to watch for in the release Wednesday.

Impact on the deficit

The CBO estimated the American Health Care Act, in its unrevised form, would have saved $337 billion over the next 10 years. This number is important because if Republicans seek to pass both tax reform and health care reform through the reconciliation process, the tax cuts associated with health care provide a lower baseline for the tax overhaul to be revenue neutral.

If the CBO finds the new bill does not save at least $2 billion over the next decade, the bill would not be passable under reconciliation and will be sent back to the House for another round of voting. That could be problematic considering the bill slid by on a vote of 217-213 earlier this month.

Will more people lose coverage?

A big criticism of the Republicans’ original health care push centered on the CBO’s estimate that the bill would lead to a loss in coverage for 24 million additional individuals through the year 2026. The attachment of two new amendments to the bill, largely targeting provisions left over from the Affordable Care Act, is unlikely to significantly lower that figure, experts say.

Effect of the MacArthur amendment

One of the biggest changes made to the bill came in the form of the MacArthur Amendment, credited with garnering the support of members belonging to the House Freedom Caucus. This provision allows state governments to apply for waivers to opt out of “essential health benefits,” so long as the state can prove that the exemption will produce results meeting certain criteria. The amendment also provides an extra $8 billion to states who opt out of pre-existing conditions coverage to set up high-risk pools.

Trump administration’s reaction

The Trump administration has downplayed the impact of the CBO’s scoring, insisting this bill is part of a larger overall agenda to reduce regulations, costs and will be supplemented with additional legislation. Office of Management and Budget director Mick Mulvaney went so far as to say the CBO score was “wrong” back in March when the last estimates were released.